"The Centers for Disease Control and Prevention claims that 20% of Covid infections can result in long Covid. But a U.K. study found that only 3% of Covid patients had residual symptoms lasting 12 weeks. What explains the disparity? It’s often normal to experience mild fatigue or weakness for weeks after being sick and inactive and not eating well. Calling these cases long Covid is the medicalization of ordinary life.
"Two studies published this month put long Covid in perspective. The first, in the Journal of the American Medical Association, looked at a spectrum of wellness indicators in 1,000 people who recovered from symptomatic Covid or who recovered from symptomatic Covid or another respiratory infection. It found that 40% of patients who had tested positive for Covid “reported persistently poor physical, mental or social well-being at 3-month follow up.”
“For Covid negative patients who had other upper-respiratory infections, the figure was 54%. Covid patients did better than non-Covid patients. While there are certainly unique hallmark conditions of Covid, such as loss of smell, any respiratory infection – flu, RSV, other cold viruses – can knock you down for a while.”
I went into Covid kind of middle of the road for my auditory problems. Had major improvements in how I do things as a person during and after lockdown. That is continuing for me.
My activity level in public has climbed gratefully after Covid. But between my auditory problems and getting Covid in September my verbal cognition is a little more tricky. Admittedly I am demanding more of myself and delivering. Still the memory issues seem a tad trickier.
I work less on memory than most people and more on analyzing than most people. My communications are different.
It found that 40% of patients who had tested positive for Covid “reported persistently poor physical, mental or social well-being at 3-month follow up.”
“For Covid negative patients who had other upper-respiratory infections, the figure was 54%. Covid patients did better than non-Covid patients. While there are certainly unique hallmark conditions of Covid, such as loss of smell, any respiratory infection – flu, RSV, other cold viruses – can knock you down for a while.”
I think this is mostly right. There are several ways to do a study about long COVID, and the easy way is just to draw up a long list of 40-50 symptoms that are associated with COVID, and then ask people, say at 3 months and at 12 months after a documented infection, whether they have any of them. These are symptoms like cough, headache, sore throat, lack of energy, you know, these things that hardly anyone has, right? And then you publish your dramatic results: 50% of people have at least one symptom of long COVID at 3 months, and 35% still have one at 12 months!
The smarter, less sensational way of doing it, is to have this thing that proper epidemiologists insist on, called a ‘control group’. You look at people that had a negative test for COVID, for instance, the same day, and you also ask THEM, 3 months and 12 months later, whether any of them has a headache or a sore throat or any of those other symptoms. And then, all of a sudden, the results are a lot less dramatic. COVID probably IS a bit worse than RSV or the flu, and particularly for chronic cough and loss of smell, and very occasionally, fatigue. But a lot of viruses will do that to you, and COVID is not very different, and not very much worse.
Up until now, almost anyone who says something that might lead people to be less worried about COVID has been shut up or shouted down or had their Twitter reach limited by people who feel that these kinds of facts and opinions are not HELPFUL in maintaining public support for isolation, quarantine, vaccination and masking. But as the consensus shifts to viewing SARS-CoV-2 as being just one more occasionally nasty virus, but not bad enough to warrant suppression of dissent, I think this sort of cold-headed, sensible analysis will start coming to the fore. At least, I hope so.
“There are several ways to do a study about long COVID
And then, all of a sudden, the results are a lot less dramatic.”
Any person who proposes hypothetical studies cannot possibly speak confidently of the ‘results’ of these imaginary studies without looking crazy.
If you have real studies that you think are interesting, share them.
If you do not, then discussing imaginary studies and their imaginary results in this way is not a great look for anyone.
Separately, it is always fascinating to see a random person on the internet announce they know best how to run a study, better than teams of epidemiologists, infectious disease experts, statisticians and other medical researchers who devoted their lives and careers to doing exactly that to the best of their abilities.
Not all studies involve control groups, for various reasons. It is not required that every piece of evidence be of the very highest gold standard in order to be useful.
Up until now, almost anyone who says something that might lead people to be less worried about COVID has been shut up or shouted down or had their Twitter reach limited
suppression of dissent
Something to ponder:
Does this sound like the person writing is a coldly-analytical, rational, scientifically/medically trained professional?
Or does it sound like the words of a conspiracy theorist who is quite out of their depth?
“Probably is a bit worse than RSV”? <— is this meant to be some kind of sick joke?
Many millions lie dead and tens of millions more remain permanently injured. In the US alone, it took massive lockdowns, emergency vaccine and medicine development, mask-wearing rules etc just to hold the death rate down to ‘far worse than flu/cold’.
This one disease has effectively burned out the reserves of the entire medical system of the planet in just 2 years. Don’t take my word for it; ask any ICU doctor or general practioner directly.
Covid is extremely different to RSV or the flu. Covid is a systemic, primarily cardiovascular disease that causes long term endothelium and clotting disorders but happens to involve short-term respiratory symptoms. It is a disease that induces immune dysfunction. Besides the endothelium (blood vessel lining), it invades and causes damage in a wide range of organs, frequently including the heart, the kidneys and the brain. It is essentially a clotting disease that happens to also make you cough - since the cough is the obvious symptom, that’s what ordinary people characterise it by. Psychiatric symptoms (anxiety, depression, dementia, psychosis) are also found, frequently long term sensory system damage. This makes it substantially different to respiratory infections like the cold. Have you ever heard of ‘covid toes’ happening commonly with a regular cold? Massive strokes?
"COVID-19 is an evolving systemic inflammatory pandemic disease, predominantly affecting the respiratory system. Associated cardiovascular comorbid conditions result in severe to critical illness with mortality up to 14.8 % in octogenarians. The role of endothelial dysfunction in its pathogenesis has been proposed with laboratory and autopsy data, though initially it was thought of as only acute respiratory distress syndrome (ARDS). The current study on endothelial dysfunction in SARS CoV-2 infection highlights its pathophysiology through the effects of direct viral-induced endothelial injury, uncontrolled immune & inflammatory response, imbalanced coagulation homeostasis, and their interactions resulting in a vicious cycle aggravating the disease process. "
"The COVID-19 disease is a multisystem disease due in part to the vascular endothelium injury. Lasting effects and long-term sequelae could persist after the infection and may be due to persistent endothelial dysfunction. "
“The most prevalent ongoing symptoms are fatigue, dyspnea, chest pain, joint pain, palpitations, anosmia and dysgeusia, hair loss, cognitive symptoms, and psychosocial distress”
The effects of long covid are diverse not only in terms of individual response but also in terms of covid variants.
" In the context of the ongoing COVID-19 pandemic and its emerging variants, directing more attention to long COVID-19 that is caused by unique strains, as well as implementing targeted intervention measures to address it are vital."
" Except in cases of systemic symptoms, existing evidence has shown that long COVID-19 can also involve multiple systems, including the mental, nervous, respiratory, cardiovascular, digestive systems, etc."
But as the consensus shifts to viewing SARS-CoV-2 as being just one more occasionally nasty virus
“Just one more ‘occasionally nasty’ virus” is absolutely NOT the consensus among anyone who specialises in viruses, epidemiology, or infectious diseases, nor is it shifting in that direction. Covid continues to have devastating impact on health systems around the world, despite incredibly effective vaccines and medicines like paxlovid, monoclonal antibodies, investment in ICUs and ventilators and novel treatment techniques.
I think this sort of cold-headed, sensible analysis
what… like this… ?
Up until now, almost anyone who says something that might lead people to be less worried about COVID has been shut up or shouted down or had their Twitter reach limited
I am not describing hypothetical studies, I am saying there are good studies (that have a control group) and there are bad ones. If you want to get everyone worked up about how terrible covid is, you reach for a bad one, and you can get rates of long covid about as high as you want them to be. If you are more concerned about what the true rate is, you look at controlled studies, allowing for the establishment of some kind of baseline for the prevalence of symptoms like cough and headache and fatigue that are very common, and seeing how much more common they are (if at all) in people who have had a case of covid.
No points for guessing which kind of study you will be mentioning…
Scientifically nothing is called a “real” study. It is just a study and very often proven wrong later.
The hypotheticals matter for scientific contemplation.
The real calming effect in the public view of covid Omicron does not get into the lungs as Delta did. Omicron generally can not do nearly as much damage. That was less a scientific study and just simple doctoring seeing that on the wards with Omicron.
That is not quite fair and to be honest a bit naive (as is the WSJ editorial). You are conflating two legitimate scientific objectives, so your labeling of “good” and “bad” is, well, bad. The first is to determine the severity of the Covid illness. The second is to compare Covid to other illnesses. Both are legitimate and necessary. The first is something the medical community needs to know as soon as possible for obvious reasons. The second provides some nuance to the first that allows fine-tuning of the medical response.
The naive part comes from not recognizing that the severity and frequency of long Covid is a moving target. Both were more problematic prior to the vaccines with populations that had no immunity to the disease. Covid symptoms have since been mitigated by the increasing immunity of the population. Strong concerns for Covid and long Covid were justified early on and are gradually becoming less so. Characterizing these earlier concerns as an exaggeration fails to take into account that the disease was far more severe at one time.
In any case, studies have been done comparing long term Covid to other illnesses and they are not particularly controversial. For example, a 2021 study shows that the incidence of long term symptoms from Covid is about 16% more frequent than occurs with influenza with the difference statistically significant. That strikes me as a legitimate matter of concern but just my opinion.
I think most of the shouting down and, in particular, disinformation and outright lies about Covid have come from your side of the aisle. Masks for example are a cheap and effective method of mitigating the effects of Covid. Those unconcerned about Covid made it a political symbol.